It’s not.

Suicide bombing and targeting aid workers purposely shred the principle that war is between armed combatants. Rules of war or fighting aren’t an intellectual exercise. Protecting civilians is a vital principle if there is to be a nod to humanity and human rights in a battle zone. Bystanders to war should not become legitimate targets of war. Yet, it is happening more and more as these two stories from Devex indicate. And another looking at why aid work is risky.

What may be most scary about these attacks is that it’s hard to see how to restore the notion of civilians’ right to protection and need to be differentiated from combatants. Former U.N. Secretary General Kofi Annan’s attempt to spread a Responsibility to Protect Civilians always will be limited because it is aimed at heads of state and governments, not at rebels and militias who also commit these atrocities. The easy accessibility of weapons gives the smallest band of thugs the ability to inflict damage that make foes and a larger public take notice. Thugs like the attention, like the destruction — that is victory enough for them. Any ideas on how to stem attacks on civilians?

First, though, I need to comment on the press release below that I got last week. It laments that kids in an orphanage in Haiti weren’t allowed out of the country. I know nothing about this group, never heard of it. But the attitude that permeates this press release is that children are commodities to be moved around at the will of unrelated adults who think they know best. And when they’re poor children, especially poor children of color, why, it’s even more reason for foreigners to move them away from their homeland. What arrogance. What cavalier dismissal of these kids’ homeland, no matter how poor or ailing it is, and the attachments they hold to it, not to mention to whatever relatives they still may have in Haiti. It’s a good bet that some of these “orphans” still have living parents. I do feel for the prospective adoptive parents, but the kids should be the most important consideration, not any adults. So cheers for the Haitian government in slowing down these kids departure. In crises like the one Haitians are going through now, it’s way too easy to take advantage of kids. This story from Reuters confirms that such exploitation is, indeed, happening in Haiti.

The press release from the group, For His Glory Adoption Outreach, is pasted after descriptions taken verbatim from organizations’ Web sites of what some child-focused groups are doing in Haiti.

UNICEF

Photo from UNICEF

Assistance to unaccompanied children, who have lost or became separated from their families, is a focus of UNICEF’s Haitian humanitarian operations, in the wake of the deadly earthquake which struck on 12 January.

While it continues daily delivery of critical life-saving supplies such as water, nutrition, shelter and medicine (so far, UNICEF supplies for 250,000 children have arrived and are being distributed), UNICEF and partners like Save the Children have also begun registering unaccompanied children found in the streets of  Port au Prince. A programme will then begin to trace the families of these children, if they exist.

“Safe Spaces” for unaccompanied children including infants are now set up in the capital. These locations allow UNICEF and its partners to assist and protect children who have nowhere else to go, until their families are found or alternative arrangements are made.

Save the Children

PORT-AU-PRINCE, Haiti (Jan. 30, 2010) — Seventeen days after the catastrophic 7.0-magnitude earthquake hit Haiti, Save the Children is distributing food rations to 200,000 children and families in partnership with the World Food Program.

Latest Field Report Highlights

• 144,158 beneficiaries have been reached to date. including medical supplies for about 85,000 in Leogane, Jacmel and Port-au-Prince.
• Our mobile clinic in Leogane continues seeing patients, roughly 100 per day. 70 health workers were trained in Leogane and another mobile clinic was established in Jacmel.
• 16 Child Friendly Spaces were established in Jacmel and Port-au-Prince, providiing activities for over 10,400 children for the past 10 days.

Orphans Blocked From Departing Haiti

Undefined Haitian exit procedures halts departure of humanitarian
paroled orphans

Port-au-Prince, Haiti (MMD Newswire) January 26, 2010 --
Seventy-nine of the 106 children from Maison des Enfants de Dieu
(Children of the House of God) orphanage, who were granted
humanitarian parole, arrived in Florida on Saturday, January 23rd.
The Haitian Government has blocked the remaining 27 children,
including the adopted son of the For His Glory (FHG) Adoption
Outreach President, Kim Harmon, from departing Port-au-Prince. In
a surprise announcement, Haitian Prime Minister Bellerive stated
that all future cases of humanitarian parole would have to complete
an exit process with his office. He has not yet defined this exit
process so no action can be taken to bring the remaining children to
their adoptive parents in the United States.

The Maison des Enfants de Dieu orphanage staff announced that
they soon would be accepting 30 children orphaned since the
January 12th earthquake. Over the past week, the orphanage has
received numerous requests to take newly orphaned children. In
one instance alone, it was asked to accept 70 orphans. The
orphanage and FHG remain firmly committed to the children and the
people of Haiti. Pat Flowers, an FHG board member who has been
in Haiti this past week consulting with the orphanage staff, agreed,
"we must act responsibly in accepting new orphans to ensure that
we will have sufficient supplies and facilities to care for these
children." Pat explained that not only is each child, who is united with

adoptive parents, helped, but much-needed space is opened up at
the orphanage to help other children. He added, "The need in
Port-au-Prince is great."

Kim Harmon reiterated the need to quickly complete the departure
process of the remaining 27 children, who have been granted
humanitarian parole. She stated "These children have adoptive
families waiting to care for them in the United States. The faster we
resolve the departure issue, the quicker we will be able to reach out
to those unfortunate children in Port-au-Prince who now have no
one." FHG urges adoptive parents, supporters and all those
concerned about the welfare of the orphans in Haiti to contact their
Congressmen, Senators, Governors and the White House to urge
the Secretary of State to quickly resolve this issue with Prime Minister Bellerive.

Secretary of State Clinton will always be a lightning rod for people who are at odds with her or her husband, former President Bill Clinton. I remember back when Bill Clinton was making his first run for president, and there were wild stories out there that said Secretary of State Clinton’s legal writings urged children to rule over their parents, I looked up her writings. They were good, solid pieces that made strong arguments on children having rights, not becoming their own parents in terms of decisionmaking. Her positions had been totally skewed.

Now she is secretary of state and few people have talked about how she has buckled down and gotten off to an excellent start. (Ironically, I think one person who did note that was Pat Buchanan). She has done what she did as a freshman senator: quietly worked hard. Her voice was loudest in Africa, and I suspect that was so because she is passionate about the issues many Africans face, and she is especially passionate about the issues African women face and the roles they could be playing in making their communities and countries better.  

And thank goodness for that, too.

Highlighting women’s abilities and the constraints in many African countries that bar them from using their talents, isn’t just some sort of kooky feminist show, as some critics make it seem. Hillary is exactly right — and those involved in serious development work know it — that women hold the key in their countries to economic progress and improved family health and life. Many of the most effective social and economic programs were started and are run by women, who then put the money they earn to use for the betterment of their children, families and their communities.

Certainly not all poor men are wasteful and women are upstanding. I help support a young lady in Uganda and her mother has drunk away some of the money I have given her to support their family. But go to any poor twon, any poor village or displacement camp, and you’ll see many men simply nto contributing their share to their families’ well-being. Women need to be given as many opportunities and as much support as possible to step up amd contribute when men cannot or will not.     

Women in Africa are an untapped economic engine that can help lift their countries. 

Thank goodness Hillary understands that.

Mosquito net mural in Bungoma, Kenya

Stef Schiffer commented on my previous post about what Concern Worldwide was doing for World Malaria Day, arguing that bed nets was just a Western feel-good initiative. The comment included this site, with a well-done video.  Thanks to Stef for telling me about it. The people on the video, many of them first- and second-generation Africans, make a good point, that the causes of mosquitos becoming malaria carriers in the first place are not cured by bed nets. That is certainly worth emphasizing, as is the role insecticides play in causing illnesses, directly and indirectly, to residents of poor countries.

But I generally reject false either-or debates. It’s not a question of bed nets OR reducing chemicals and insecticides in African and other nations. If one way to reduce the chances that a child - or adult - in a malarial-prone country will contract malaria is by having him or her sleep under a bed net, then why the hell not use that as one tactic? There are other approaches, beyond looking at chemicals and using nets, such as speeding up research of an anti-malarial vaccine.

In Uganda

Would the folks on that video condemning bed nets also agree that birth control is irrelevant to preventing unwanted pregnancies and transmission of certain diseases because the underlying cause is having sex in the first place? That seems to me the possible extension of their argument. I say come at a problem, especially one that takes so many lives, from as many directions as possible. Here’s a good Web site, from the Kaiser Family Foundation, to learn more about malaria.

The secret weapon in fight against global killer

April 25 is World Malaria Day

Malaria kills up to 1 million people each year—mostly children under five, more than 90 percent of them from sub-Saharan Africa. Half the world’s population—3.3 billion people in 109 countries—are at risk, and almost 250 million contract the disease each year.

“A vaccine is probably many years away, if not still a dream,” says Michelle Kouletio, Health Advisor for Concern Worldwide, the international relief and development agency. “But we have the tools to effectively prevent and treat malaria.” she adds, and “a simple solution with dramatic results is the distribution of long-lasting and insecticide-treated mosquito nets and showing people how to use them.”

“Mobilizing communities to manage their own health care is the secret weapon of our Rwanda program,” says Kouletio. “Simply distributing nets is not enough. That’s only part of the solution—the second vital ingredient is education. Knowledge is power: community health volunteers show their neighbors how to safely hang the nets in the small, crowded homes where the most vulnerable children often live.”

In Rwanda, Concern began distributing subsidized nets to pregnant women in 2004. The program was so successful that the Rwandan government was able to secure Global Funds to procure millions of nets to distribute to all families with young children. Just months after the October 2006 net campaign, the number of cases of malaria was cut in half, reports Kouletio, who oversees the USAID funded Expanded Impact Child Survival program, a Concern led partnership with the International Rescue Committee and World Relief.  It covers six districts reaching 20 percent of all Rwandans.

“These nets only cost less than $8 apiece and, once distributed, the nets provide protection for several years—at a cost far less than the $20 cost of spraying of homes with insecticide, a procedure that has to be repeated several times a year and poses environmental health hazards,” Kouletio explains.

Concern trains and forges connections among community elders, healthcare professionals, government officials, and the families themselves. Specially trained and equipped Community Healthcare Workers (CHWs) are at the core of this community effort.

Concern trains the CHWs to instantly identify symptoms—fever, chills, convulsions—and to educate families about potentially harmful home remedies and traditional healing practices. “The CHWs,” says Kouletio, “provide treatment on the spot to children with symptoms of uncomplicated malaria.”
“They are well known and trusted members of the community,” she says, “with ready access to families’ homes. They are the “ordinary heroes” who are at the heart of this treatment of malaria. “Having health care workers based in the community is essential,” continues Kouletio—“they can intervene rapidly—and time is of the essence.”

“In its past two years alone, our program has treated more than 180,000 Rwandan children under five for malaria,” reports Kouletio. The success of this program has brought about significant changes in the country’s policy for treating malaria and has opened the door for community treatment of the other two leading child killers, pneumonia and diarrhea.

Concern works in 28 of the world’s poorest countries, including 17 sub-Saharan African nations, and reaches some 23 million people. The organization’s goal is the ultimate elimination of extreme poverty and the reduction of suffering. The organization’s programs focus on emergency relief and long-term development work in the areas of health, HIV and AIDS, livelihoods and education. Concern’s education programs are benefitting more than 465,000 people in 12 countries.

According to Population Action International: “The policy disqualifies foreign non-governmental organizations (NGOs) from receiving U.S. family planning funds if they provide legal abortion services in cases other than a threat to the life of the woman, rape, or incest; if they provide counseling and referral for abortion; or if they lobby to make abortion legal or more available in their own country.”

Photo Credit: Barbara Kinzie, Jhpiego

It also wasted precious U.S. aid money by impeding the improvement of women’s health care in desperately poor nations. Studies repeatedly have shown that one of the main engines of development is the improved status — physical and material — of women. To deny women a full range of medical information and treatment (and I’m not talking about abortion here) is to construct obstacles to economic progress for entire families in struggling parts of the world where women not only care for the children and the home, but often do the farming or other income-generating activities. It’s putting ideology above people and pragmatism.

The policy was first instituted in 1984 by President Reagan. It h been on a yo-yo ever since, with Democratic President Bill Clinton lifting it in 1993 and Republican President Bush reviving it in 2001. So Obama doesn’t need simply to claim his date on the calendar when he rescinded the policy. He needs to figure out how to prevent the policy from being reinstated.  

The obvious solution is a legislative one. That route was attempted in September 2007, when U.S. Sen. Barbara Boxer (D., Calif.) and U.S. Rep. Nita Lowey (D., N.Y.) introduced an amendment to a State Department funding bill that would have lifted those restrictions to U.S. aid as set out in Mexico City policy.  President Bush scuttled their effort by signing an executive order, which modified the rule, but still hamstrung women’s health groups.

There needs to be another legislative effort that rescinds the restrictions on U.S. aid for family planning and women’s health and funds an aggressive education campaign to promote abortion only in the cases of incest, rape and the life of the mother. Abortion should not be used as contraception in other cases. 

One of the other big problems with he global gag rule is that it showed U.S. ignorance about the status and rights of women in many developing countries. A nuanced, pragmantic policy that uses education to address the problem that comes with abusive practices against women will have a far more enduring impact on reducing the incidence of unnecessary abortions while providing women with a full range of health care.

See report here